Chances are, if you had to report under PQRS in 2016, you'll need to report in 2017, but there are some exceptions. The chart in this post helps provide an easy to read explanation of who has to comply!

By the end of January 2016 there were 838 ACOs operating across all fifty states and Washington DC. Today ACOs are paid under different models and considered part of different tracks; most commonly the Track 1 Medicare Shared Savings Program (MSSP) model, but also Track 2 and Track 3 programs such as Next Generation ACOs and Pioneer ACOs. According to CMS, 95% of all ACO’s are considered a Track 1 ACO... All Track 1 ACOs, meaning 95% of all ACOs, are not eligible for Advanced APM status. In other words, 95% of ACOs must report through MIPS.

In November, CMS issued its final ruling on the Medicare Access and Chip Reauthorization Act (MACRA). This ruling was the largest change in Medicare in over a decade – pushing completely away from volume based care towards a new era of value-based care. MACRA created MIPS, the Merit-Based Incentive Payment System. This new law and corresponding implementation will have a particularly harsh impact on Critical Access Hospitals (CAHs); exempt from previous programs and generally operating with limited resources, CAHs are at a distinct disadvantage when attempting to comply with MIPS.

Many providers elect not to file MIPS data, stating that it is too difficult or not worth their time. However, with penalties increasing every year, few practices can afford not to file. Health eFilings simplifies MIPS reporting, using the electronic filing method set up by CMS. Practices are able to save time and money, with a completely automated process that requires no work on their end.